December 18, 2017
Area(s) of Interest: Physician Leadership Physician Wellness
||Edward Ellison, M.D
“Physicians are ailing,” says Edward Ellison, M.D.
He wants the public to know about it and to thank their physicians, he wants governing bodies to understand the toll their reporting and oversight requirements are taking on physicians, and he wants the physicians who lead medical schools, residency programs and medical groups to change the nature of being a physician from one of suffering to one of health and well-being.
Dr. Ellison is in a position—or more accurately, many positions—to effect that change. Since 2012, he has been Executive Medical Director and board chair of the Southern California Permanente Medical Group. He is also board chair and CEO of the Southeast Permanente Medical Group, comprised of 500 physicians in the cities of Atlanta and Athens, GA, and surrounding areas. He is co-CEO of the nationwide Permanente Federation. And he is a member of the board of directors of the soon-to-be Kaiser Permanente School of Medicine, under construction in Pasadena. He was also part of an AMA consortium of 10 physician leaders of major medical groups, including the Mayo and Cleveland clinics and several academic medical centers, drawn together in 2016 to propose solutions to the physician burnout crisis, which jeopardizes the quality of care and is pushing more and more physicians to leave the profession.
Dr. Ellison is so concerned about physicians’ unhappiness in a profession they once loved that he presented the grim picture to a public, nonmedical forum, the 2017 TEDxNaperville conference in the Chicago area this November. Among the causes of burnout, Dr. Ellison, said are that physicians, who are by nature perfectionists, feel they have lost control over their work and are “being measured on everything they do.” The electronic health care records and reporting requirements have created inefficient workflows and less time for patients, which “feel like a gigantic pile-on.” He noted that surveys of physicians conducted in 2011 and again in 2014 showed that numbers of physicians experiencing at least one symptom of burnout rose to 54.4 percent from 45.5 percent.
“But it gets darker,” Dr. Ellison said. “In the last two years data show that the rate of suicide among male physicians is 40 percent higher than that of the general public,” with female physicians’ suicide rate “130 percent greater than the general public.” In fact, he said, “The rate of suicide among physicians is similar to that of combat veterans.”
Much of the problem, too, begins in medical school with many physicians entering practice after residency training already “broken and beaten,” Dr. Ellison said. He noted that two of his medical school classmates killed themselves before beginning their internships. He described his early career within the traditional “lockstep” regimen of American medical education: “I did the training. I went without sleep. I ate junk. And I learned and I suffered. But I was also inspired by the gratitude of my patients and the satisfaction of knowing I was making a difference in people’s lives. So I did more and I asked for more and took on more, as my colleagues do.”
Now, however, having been “called to leadership,” and being a “co-leader of one of the largest groups of physicians in the world—21,000 doctors taking care of almost 12 million patients,” he said, “I have gained perspective. I have heard the cries.” He said it is time that society “recognize and care about the lives of those who save lives.”
Within SCPMG, he spearheaded a physician wellness program focusing on physicians’ health and on burnout prevention. For the physicians of the future he wants a total transformation of the American medical culture. “We need to change our thinking,” Dr. Ellison says, “and change our culture inside and outside of the medical profession across society…We have to declare our physicians’ humanity.”
Permanente, he says has a “path forward” beginning with its new medical school. As well as teaching students to be exceptional physicians, which is “nonnegotiable,” he says, “We are going to teach them that their wellness matters. We are going to provide support for them and connect them with each other and resources. We are going to teach them how to set healthy boundaries for their own wellness and about how prevention and nutrition work not just for their patients but for themselves.”
For whatever kind of medical system—small practice, large practice, academic institutions—that the students set their sights on, he says, ““We’re going to teach them how to work within theses systems to change these systems so they’re not buffeted about [and] they can be advocates for change.”
“I still love my profession,” Dr. Ellison says, and he hopes young people, “those bright shining stars,” will continue to seek it out.